Open AccessImpact of body fat distribution on long-term clinical outcomes after drug-eluting stent implantation
Author(s) -
Se-Jun Park,
Hong Seok Lim,
Seungsoo Sheen,
HyoungMo Yang,
KyoungWoo Seo,
SoYeon Choi,
ByoungJoo Choi,
MyeongHo Yoon,
SeungJea Tahk
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0197991
Subject(s) - mace , medicine , conventional pci , percutaneous coronary intervention , myocardial infarction , hazard ratio , cardiology , body mass index , quartile , proportional hazards model , drug eluting stent , body fat percentage , confidence interval
Background and objective The distribution of body fat is closely related to cardiovascular disease and outcomes, although its impact on patient prognosis after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) has not been evaluated. We investigated the impact of truncal fat distribution on long-term clinical outcomes after DES treatment. Methods In 441 DES-treated patients, dual energy X-ray absorptiometry was performed to assess total and regional body fat distribution after index PCI. The ratio of truncal fat to total body fat mass (%FM trunk /FM total ) was calculated as a representative parameter for truncal fat distribution. The primary endpoint was major adverse cardiac events (MACE), a composite of ischemia-driven target vessel revascularization (TVR), non-procedural myocardial infarction, cardiac death at 5 years. Results During the median follow-up duration of 1780 days, MACE occurred in 22.0% of patients, with the highest-quartile group of %FM trunk /FM total having a higher rate than the lowest quartile group (27.8% vs. 15.3%; log rank p = 0.026). The difference was driven by a higher rate of ischemia-driven TVR (25.9% vs. 9.9%; log rank p = 0.008). In multivariable Cox regression analyses, %FM trunk /FM total was independently associated with MACE (hazard ratio: 1.075; 95% CI: 1.022–1.131; p = 0.005), but body mass index (BMI) was not. Conclusions In DES-treated patients, truncal fat distribution is associated with unfavorable clinical outcomes and is more clinically relevant than BMI.